Electronic Medical Records (EMR) Tobacco Protocol

The eTobacco Protocol is an electronic tobacco cessation referral tool integrated into electronic medical records (EMRs) that allows providers to refer patients to the Texas Quitline with the click of a button. The Quitline is funded by the state of Texas and provides counseling to people who wish to quit tobacco at no charge. The Quitline provides nicotine replacement therapy to eligible participants who are referred by their healthcare provider. Integration of the eTobacco Protocol into a patients' EHR helps avoid the time-consuming, paper fax referral and provides a proactive way to engage tobacco users in the process of quitting.

The eTobacco Protocol is designed to be integrated into the electronic medical record (EMR) to electronically refer patients to the Quitline. The eTobacco Protocol has the potential to help meet Meaningful Use metrics, add value to services provided, and improve patient outcomes through risk reduction. The Protocol prompts health care providers to assess their patient’s readiness to quit tobacco within 30 days, and with the patient’s approval and a click of a button, a patient referral is made to the Quitline. Following a referral to the Quitline, a Quitline counselor calls the patient within 48 hours to begin the process of tobacco cessation efforts.

Ask-Advise-Refer is an approach that can be used by health care staff:

Ask: Assess and document each patient’s tobacco status (currently uses, has quit, or has never used) at every visit. Consider this an additional vital sign. The non-smoking patient’s exposure to secondhand smoke should also be documented.

Advise: Use a clear, strong and personalized message to urge every tobacco user to quit. Use teachable moments and link current conditions as reasons to quit using tobacco.

Refer: Make a referral to the Quitline or available resources, during the visit, at the end of the visit, after the visit, during hospital stay, or at discharge from hospital.